Showing papers on "Driving under the influence published in 2016"
TL;DR: Recovery of cannabis-impaired driving is associated with a statistically significant increase in motor vehicle crash risk, and the increase is of low to medium magnitude.
Abstract: AIMS: To determine whether and to what extent acute cannabis intoxication increases motor vehicle crash risk. DESIGN: Study 1 replicates two published meta-analyses, correcting for methodological shortcomings. Study 2 is an updated meta-analysis using 28 estimates from 21 observational studies. These included studies from three earlier reviews, supplemented by results from a structured search in Web of Science and Google Scholar and by the personal libraries of the research team. Risk estimates were combined using random effects models and meta-regression techniques. SETTING: Study 1 replicates the analysis of Asbridge et al., based on 9 studies from 5 countries, published 1982-2007; and Li et al., based on 9 studies from 6 countries, published 2001-10. Study 2 involves studies from 13 countries published in the period 1982-2015. PARTICIPANTS: In Study 1, total counts extracted totalled 50 877 (27 967 cases, 22 910 controls) for Asbridge et al. and 93 229 (4 236 cases and 88 993 controls) for Li et al. Study 2 used confounder-adjusted estimates where available (combined sample size of 222 511) and crude counts from the remainder (17 228 total counts), giving a combined sample count of 239 739. MEASUREMENTS: Odds-ratios were used from case-control studies and adjusted odds-ratio analogues from culpability studies. The impact of the substantial variation in confounder adjustment was explored in subsample analyses. FINDINGS: Study 1 substantially revises previous risk estimates downwards, with both the originally reported point estimates lying outside the revised confidence interval. Revised estimates were similar to those of Study 2, which found cannabis-impaired driving associated with a statistically significant risk increase of low-to-moderate magnitude (random effects model odds ratio 1.36 (1.15-1.61), meta-regression odds ratio 1.22 (1.1-1.36)). Subsample analyses found higher odds-ratio estimates for case control studies, low study quality, limited control of confounders, medium quality use data, and not controlling for alcohol intoxication. CONCLUSIONS: Acute cannabis intoxication is associated with a statistically significant increase in motor vehicle crash risk. The increase is of low to medium magnitude. Remaining selection effects in the studies used may limit causal interpretation of the pooled estimates. Language: en
228 citations
01 Jan 2016
TL;DR: Large national surveys found that young adults ages 18-25 were at particularly high risk of alcohol use disorder and unintentional injury caused by drinking, and white respondents reported the highest prevalence of current alcohol consumption, whereas alcohol abuse and dependence were most prevalent among Native Americans.
Abstract: Alcohol consumption is common across subpopulations in the United States. However, the health burden associated with alcohol consumption varies across groups, including those defined by demographic characteristics such as age, race/ ethnicity, and gender. Large national surveys, such as the National Epidemiologic Survey on Alcohol and Related Conditions and the National Survey on Drug Use and Health, found that young adults ages 18-25 were at particularly high risk of alcohol use disorder and unintentional injury caused by drinking. These surveys furthermore identified significant variability in alcohol consumption and its consequences among racial/ethnic groups. White respondents reported the highest prevalence of current alcohol consumption, whereas alcohol abuse and dependence were most prevalent among Native Americans. Native Americans and Blacks also were most vulnerable to alcohol-related health consequences. Even within ethnic groups, there was variability between and among different subpopulations. With respect to gender, men reported more alcohol consumption and binge drinking than women, especially in older cohorts. Men also were at greater risk of alcohol abuse and dependence, liver cirrhosis, homicide after alcohol consumption, and drinking and driving. Systematic identification and measurement of the variability across demographics will guide prevention and intervention efforts, as well as future research.
161 citations
TL;DR: A proof-of-concept disposable breathalyzer using an organic electrochemical transistor modified with alcohol dehydrogenase (ADH) as the sensor and printed OECT, which easily detects ethanol in the breath equivalent to BAC from 0.01% to 0.2%.
Abstract: The euphoria from drinking alcoholic beverages makes them popular worldwide. Abuse in alcohol (ethanol) consumption leads to dependence, behavioral problems, and fatal accidents1. In 2013, 10,076 people lost their lives in alcohol-related-driving accidents in the United States alone, accounting for nearly 31% of all traffic related deaths1. Driving under the influence is illegal and the maximum allowed blood alcohol concentration (BAC) is 0.05–0.08%, in most countries2. A breathalyzer measures the concentration of ethanol in the breath to estimate the BAC of an individual. The first generation of breathalyzers uses a liquid dye sensitive to ethanol exposure, potassium dichromate, and a photodetector3. Reliability of these detectors is a challenge and potassium dichromate is environmentally toxic3. A new generation of breathalyzers uses the ethanol in the breath to power a fuel cell whose output is proportional to the ethanol concentration4. These breathalyzers are connected directly to smart phones to test one’s alcohol level before attempting to drive. However, these breathalyzers are still impractical because they require constant recalibration4. To-date the most reliable BAC tests and the only one that is admissible in court is the blood test, which is difficult to administer on site or for preventative purposes. A breathalyzer as easy to use as an inexpensive and disposable glucose paper-strip sensor would greatly simplify BAC testing5.
Organic electrochemical transistors (OECTs) are excellent candidates for disposable biosensors because they are inexpensive, they can be made on flexible substrates, and they can be printed on paper6,7. OECTs are typically made with poly(3,4-ethylenedioxythiophene) doped with poly(styrenesulfonate) PEDOT:PSS. PEDOT:PSS is a p-type organic semiconductor with several applications in bioelectronics8,9. Coupled with enzymes in the electrolyte, PEDOT:PSS OECTs are able to detect micro molar glucose concentration in human blood and sweat10. OECTs sensors are amenable to screen-printing11 and inkjet printing12 for rapid and inexpensive manufacturing. Here, we demonstrate an early stage proof-of-concept OECT-breathalyzer on paper by integrating a PEDOT:PSS OECT with the enzyme alcohol dehydrogenase. This proof-of-concept OECT-breathalyzer may aid the development of a breathalyzer that is easy-to-use, inexpensive, easily calibrated, and can be coupled with a cell-phone or a smart watch for BAC self-testing to reduce alcohol related traffic accidents.
121 citations
TL;DR: Although the correlation between blood or oral fluid concentrations and psychoactive effects of THC needs a better understanding, blood sampling has been shown to be the most effective way to evaluate the level of impairment of drivers under the influence of cannabis.
104 citations
TL;DR: The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads.
Abstract: Nowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20–50 million sustain severe injuries, the majority of which require long-term treatment. The objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles. The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.
102 citations
TL;DR: It is found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays.
Abstract: Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays.
95 citations
TL;DR: This paper proposes a method based on association rules to analyze the characteristics and contributory factors of work zone crash casualties and shows that almost all the high-lift rules contain either environmental or occupant characteristics.
90 citations
TL;DR: NPS were very often detected in the blood of drivers which was a challenge for toxicologists due to a lack of data on their influence on psychomotor performance, especially driving under the influence of drugs (DUID) and intoxication.
Abstract: New psychoactive substances (NPS) pose a challenge for forensic and clinical toxicologists, as well as for legislators. We present our findings from cases where NPS have been detected in biological material. During the three-year period 2012-2014 we found NPS in 112 cases (out of 1058 analyzed), with 75 cases in 2014 alone. The prevalence of all NPS (15.1-17.6%) was similar to amphetamine alone that was detected in 15.1-16.5% of cases. The new drugs found belonged to the following classes: cathinones (88%), synthetic cannabinoids (5%), phenethylamines (3%), piperazines and piperidines (3%), arylalkylamines (1%) and other (1%). The drugs detected were (in the order of decreased frequency): 3-MMC (50), α-pyrrolidinopentiophenone (α-PVP) (23), pentedrone (16), 3',4'-methylenedioxy-α-pyrrolidinobutyrophenone (MDPBP) (12), synthetic cannabinoid UR-144 (7), ethcathinone (5), mephedrone (5), methylenedioxypyrovalerone (MDPV) (4), 4-methylethcathinone (4-MEC) (3), buphedrone (3), desoxypipradrol (2-DPMP) (3), methylone (2) and 2C-B (2). In single cases, 2-methylmethcathinone (2-MMC), 2C-P, eutylone, 25I-NBOMe, meta-chlorophenylpiperazine (mCPP), ephedrone, methiopropamine (MPA), and 5-(2-aminopropyl)benzofuran (5-APB) were found. One NPS was the sole agent in 35% of all cases, and two or more NPS were present in 19% of cases. NPS (one or more) with other conventional drugs (like amphetamines, cannabinoids, cocaine, and benzodiazepines) were detected in most (65%) of the cases. NPS were very often detected in the blood of drivers which was a challenge for toxicologists due to a lack of data on their influence on psychomotor performance. A review of concentrations showed a wide range of values in different types of cases, especially driving under the influence of drugs (DUID) and intoxication.
84 citations
TL;DR: The associations between specific medication use and the increased risk of MVC and/or affected driving ability are complex and future research opportunities are plentiful.
82 citations
TL;DR: RD preference appears to be a useful marker for clarifying explanatory pathways to risky driving, and for research into developing more personalized prevention efforts.
Abstract: BACKGROUND: Road crashes represent a huge burden on global health. Some drivers are prone to repeated episodes of risky driving (RD) and are over-represented in crashes and related morbidity. However, their characteristics are heterogeneous, hampering development of targeted intervention strategies. This study hypothesized that distinct personality, cognitive, and neurobiological processes are associated with the type of RD behaviours these drivers predominantly engage in. METHODS: Four age-matched groups of adult (19-39 years) males were recruited: 1) driving while impaired recidivists (DWI, n = 36); 2) non-alcohol reckless drivers (SPEED, n = 28); 3) drivers with a mixed RD profile (MIXED, n = 27); and 4) low-risk control drivers (CTL, n = 47). Their sociodemographic, criminal history, driving behaviour (by questionnaire and simulation performance), personality (Big Five traits, impulsivity, reward sensitivity), cognitive (disinhibition, decision making, behavioural risk taking), and neurobiological (cortisol stress response) characteristics were gathered and contrasted. RESULTS: Compared to controls, group SPEED showed greater sensation seeking, disinhibition, disadvantageous decision making, and risk taking. Group MIXED exhibited more substance misuse, and antisocial, sensation seeking and reward sensitive personality features. Group DWI showed greater disinhibition and more severe alcohol misuse, and compared to the other RD groups, the lowest level of risk taking when sober. All RD groups exhibited less cortisol increase in response to stress compared to controls. DISCUSSION: Each RD group exhibited a distinct personality and cognitive profile, which was consistent with stimulation seeking in group SPEED, fearlessness in group MIXED, and poor behavioural regulation associated with alcohol in group DWI. As these group differences were uniformly accompanied by blunted cortisol stress responses, they may reflect the disparate behavioural consequences of dysregulation of the stress system. In sum, RD preference appears to be a useful marker for clarifying explanatory pathways to risky driving, and for research into developing more personalized prevention efforts. Language: en
76 citations
TL;DR: Cannabis was associated with slower driving and greater headway, suggesting a possible awareness of impairment and attempt to compensate and a less‐than‐additive THC*BrAC interaction was detected in percent speed high, suggesting cannabis mitigated drivers’ tendency to drive faster with alcohol.
Abstract: Although evidence suggests cannabis impairs driving, its driving-performance effects are not fully characterized. We aimed to establish cannabis' effects on driving longitudinal control (with and without alcohol, drivers' most common drug combination) relative to psychoactive ∆(9) -tetrahydrocannabinol (THC) blood concentrations. Current occasional (≥1×/last 3 months, ≤3 days per week) cannabis smokers drank placebo or low-dose alcohol, and inhaled 500 mg placebo, low (2.9%), or high (6.7%) THC vaporized cannabis over 10 min ad libitum in separate sessions (within-subject, six conditions). Participants drove (National Advanced Driving Simulator, University of Iowa) simulated drives 0.5-1.3 h post-inhalation. Blood and breath alcohol samples were collected before (0.17 and 0.42 h) and after (1.4 and 2.3 h) driving. We evaluated the mean speed (relative to limit), standard deviation (SD) of speed, percent time spent >10% above/below the speed limit (percent speed high/percent speed low), longitudinal acceleration, and ability to maintain headway relative to a lead vehicle (headway maintenance) against blood THC and breath alcohol concentrations (BrAC). In N=18 completing drivers, THC was associated with a decreased mean speed, increased percent speed low and increased mean following distance during headway maintenance. BrAC was associated with increased SD speed and increased percent speed high, whereas THC was not. Neither was associated with altered longitudinal acceleration. A less-than-additive THC*BrAC interaction was detected in percent speed high (considering only non-zero data and excluding an outlying drive event), suggesting cannabis mitigated drivers' tendency to drive faster with alcohol. Cannabis was associated with slower driving and greater headway, suggesting a possible awareness of impairment and attempt to compensate. Copyright © 2016 John Wiley & Sons, Ltd.
TL;DR: In this paper, a literature review study investigated the relationship between impulsivity and driver behaviors, offences and road traffic accidents through the lenses of characterological perspective, concluding that the vast majority of the studies reported significant relationships between impulsive behavior and the driving outcomes.
Abstract: The present literature review study investigated the relationship between impulsivity and driver behaviors, offences and road traffic accidents through the lenses of characterological perspective. The studies published from 1970 to 2014 that examined and reported a relationship between impulsivity and at least one driving related outcome (e.g., a self-report measure of driver behavior) were included. The relevant 38 out of 288 studies are presented in four sections based on the driving related outcomes as; (i) aberrant driver behaviors and driving anger/aggression, (ii) driving under the influence, (iii) traffic offences and accidents, (iv) other. The vast majority of the studies reported significant relationships between impulsivity and the driving outcomes. The general findings of the studies in the literature, suggestions including a new definition of impulsivity in driving context, and future directions are discussed in the scope of a proposed integrative conceptual framework. Language: en
TL;DR: Current data suggest that increases in marijuana use preceded legalization in 2012, with modest increases in poison center calls in both states and increases in acute medical visits in Denver.
Abstract: OBJECTIVES: This study presents information on the status and impact of medical and legalized marijuana, and the latest data on attitudes and prevalence of use since implementation of these laws. Recent reports from epidemiologists in Denver and Seattle are summarized to give the readers a sense of the changes as these laws have taken effect in their communities. METHODS: The status of these laws is reviewed and the results of surveys taken before and after the laws were enacted are presented, along with data on changing potency and driving under the influence of marijuana. SUMMARY: Prevalence of use by youths has not increased, but their negative attitudes towards the risk of using marijuana have decreased, and use by adults has increased. Potency continues to increase, as has the proportion of drivers testing positive for use of the drug. Data from Denver show increases in hospital admissions, emergency department visits, and calls to poison centers, with decreasing arrests and admissions to substance abuse treatment programs. Data from the Seattle area show similar decreases in treatment admissions and police involvement, but also increased prevalence of more frequent use. CONCLUSIONS: Current data suggest that increases in marijuana use preceded legalization in 2012. Treatment admissions were declining before these laws, but some indicators of morbidity seem to be increasing subsequent to legalization, with modest increases in poison center calls in both states and increases in acute medical visits in Denver. Data are needed to understand the relationship between the patterns and amounts of use in terms of consequences, and data on the health conditions of those receiving medical marijuana and the impact of higher potency. Language: en
TL;DR: The effects of seat belts on fatality and injury risk were investigated and it is estimated that the annual numbers of KSI front seat occupants in light vehicles in Norway could be reduced by 11.3% if all vehicles had seat belt reminders (assumed seat belt wearing rate 98.9%) and by 19.9%If all front seat occupant of light vehicles were belted.
TL;DR: The FTN best predicted cannabis impairment (sensitivity, specificity, positive/negative predictive value, and efficiency), utilizing ≥3 misses as the deciding criterion; MRB eyelid tremors produced the best diagnostic characteristics for all diagnostic characteristics.
TL;DR: Interventions for reducing the incidence of marijuana DUI are likely to be more successful by targeting safety perceptions related to marijuana DUI rather than knowledge of DUI laws, according to new data from a survey of marijuana users in Colorado and Washington.
Abstract: AIMS: A potential unintended consequence of legalizing recreational marijuana is increased marijuana-related driving impairment. Some states where recreational marijuana is legal have begun implementing interventions to mitigate driving under the influence (DUI) of marijuana, including media campaigns to increase knowledge about DUI laws. However, little is known about the associations between knowledge of DUI laws and marijuana DUI behavior. In this study, we provide new data from a survey of marijuana users in Colorado and Washington to examine associations between marijuana drugged driving and two potential behavioral precursors of marijuana DUI. We also explore other factors that may influence marijuana DUI. METHODS: Data are from an online survey of marijuana users in Colorado and Washington. Respondents who reported any marijuana use in the past 30 days (n = 865) served as the analytic sample. We examined prevalence of two behavioral outcomes: (1) any driving of a motor vehicle while high in the past year and (2) driving a motor vehicle within 1 hour of using marijuana 5 or more times in the past month. Additional outcomes measuring willingness to drive while high were also assessed. Logistic regressions were used to estimate each outcome as a function of two multi-item scales measuring knowledge of the legal consequences of driving high and perceptions that driving while high is not safe. Additional covariates for potential confounders were included in each model. RESULTS: Prevalence of past-year driving while under the influence of marijuana was 43.6% among respondents. The prevalence of driving within 1 hour of using marijuana at least 5 times in the past month was 23.9%. Increased perception that driving high is unsafe was associated with lower odds of past-year marijuana DUI (OR = 0.31, P CONCLUSIONS: Despite recent interventions targeting public awareness of the legal consequences of marijuana DUI, our results suggest that knowledge of these laws is a weaker predictor of DUI behavior than perceptions that driving high is unsafe. In addition, safety perceptions predict decreased openness to driving high while knowledge of DUI laws was not associated with openness. These findings suggest that interventions for reducing the incidence of marijuana DUI are likely to be more successful by targeting safety perceptions related to marijuana DUI rather than knowledge of DUI laws. We caution that because these data are limited to an online convenience sample, results may not be generalizable beyond our sample. Language: en
TL;DR: Joint interpretation of the data shows that the use of amphetamine and MDMA has increased in Finland from 2012 to 2014 and a similar trend was also observed for cocaine, although its use remains at a very low level compared to many other European countries.
TL;DR: In this paper, the authors used an experimental paradigm to delineate passive and active social influences with actual peers, and found that adolescents experienced more crashes when they had passengers who reported a strong preference for risk taking and who actively provided decision-making guidance.
Abstract: Both passive and active social influences may affect adolescents' dangerous driving. In this study, we used an experimental paradigm to delineate these two influences with actual peers. Adolescents completed a simulated driving task, and we measured risk preferences of each member of the peer group. We used hierarchical linear modeling to partition variance in risky decisions. Adolescents experienced many more crashes when they had “passengers” present who reported a strong preference for risk taking and who actively provided decision-making guidance. Although youth in the passive peer condition were also influenced by the riskiness of their peers, this relation was less strong relative to the active condition. We discuss the need for interventions focussing on active and passive peer influence.
TL;DR: Despite large differences in physicochemical properties, this simplified QuEChERS extraction method yielded satisfactory recoveries (until 96 %) for the 35 molecules and was successfully validated and applied to 253 cases of driving under the influence of drugs (DUID), collected over a 6-month period.
Abstract: Modern LC-MS/MS instruments have sensitivity and scanning velocity high enough to analyze many different compounds in single runs. Consequently, the sample preparation procedure has become the bottleneck for developing efficient, rapid, and cheap multi-compound methods. Here, we examined one-step sample preparation based on quick, easy, cheap, effective, rugged, and safe (QuEChERS) salts to set up and validate a LC-MS/MS method for the simultaneous determination of 35 drugs of abuse and their metabolites in whole blood. Despite large differences in physicochemical properties, this simplified QuEChERS extraction method yielded satisfactory recoveries (until 96%) for the 35 molecules. The amounts of QuEChERS salts had no influence on extraction yield. Chromatographic separation was obtained in less than 6 min. LLOD and LLOQ were 3 and 5 ng/mL, respectively. The procedure was successfully validated and then applied to 253 cases of driving under the influence of drugs (DUID), collected over a 6-month period.
TL;DR: The results corroborate the idea that intention and habit are distinct and direct determinants of offences and address the theoretical plausibility of the direct effects of attitude and the subjective norm.
Abstract: This study addresses the socio-cognitive determinants of traffic offences, in particular of speeding and drinking and driving. It has two aims: (1) to test the hypothesis of a direct effect of habits on offences (i.e., independent of intentions) by employing a specific measure of habits (i.e., the SRIH) and (2) to analyse the offences by taking account of three distinct parameters: Frequency, usual magnitude (i.e., the most frequent deviation from the law) and maximal magnitude (i.e., the greatest deviation occasionally adopted) in order to represent more accurately the variability of the offending behaviours. A total of 642 drivers replied to a questionnaire. The results corroborate the idea that intention and habit are distinct and direct determinants of offences. The use of the SRIH dismisses the criticisms made with regard to the measure of past behaviour. The distinction between the three behavioural parameters proves to be relevant, as their determinants are not exactly similar. Finally, attitude and subjective norm had direct effects on the maximal magnitude and/or on the frequency of the offence. The discussion concerns the contribution of this study to the analysis of offences as well as its limitations and addresses the theoretical plausibility of the direct effects of attitude and the subjective norm.
Journal Article•
TL;DR: The studies mainly concluded that there may be a significant psychomotor impairment after using benzodiazepines or related drugs, cannabis, opioids, GHB, ketamine, antihistamines, and antidepressants.
Abstract: Experimental studies on the impairing effects of drugs of relevance to driving-related performance published between 1998 and 2015 were reviewed. Studies with on-the-road driving, driving simulators, and performance tests were included for benzodiazepines and related drugs, cannabis, opioids, stimulants, GHB, ketamine, antihistamines, and antidepressants. The findings in these experimental studies were briefly discussed in relation to a review of epidemiological studies published recently. The studies mainly concluded that there may be a significant psychomotor impairment after using benzodiazepines or related drugs, cannabis, opioids, GHB, or ketamine. Low doses of central stimulants did not seem to cause impairment of driving behavior.
TL;DR: A sensitive and specific liquid chromatography-tandem mass spectrometry method for quantification of THC, its phase I and glucuronide phase II metabolites, and 5 five minor cannabinoids is developed and validated and identification of recent cannabis administration or discrimination between licit medicinal and illicit recreational cannabis use can be improved.
TL;DR: Roadside surveys showed a reduction of drunk driving over time in the studied countries; however, the pattern varied within and between different countries; the proportion of fatal RTCs related to non-alcohol drugs increased, particularly for cannabis and stimulants.
Abstract: Trends in the use of alcohol and drugs among motor vehicle drivers in Australia, Brazil, Norway, Spain, and the United States have been reviewed. Laws, regulations, enforcement, and studies on alcohol and drugs in biological samples from motor vehicle drivers in general road traffic and fatal road traffic crashes (RTCs) are discussed. Roadside surveys showed a reduction of drunk driving over time in the studied countries; however, the pattern varied within and between different countries. The reduction of alcohol use may be related to changes in road traffic laws, public information campaigns, and enforcement, including implementation of random breath testing or sobriety checkpoints. For non-alcohol drugs, the trend in general road traffic is an increase in use. However, drugs were not included in older studies; it is therefore impossible to assess the trends over longer time periods. Data from the studied countries, except Brazil, have shown a significant decrease in fatal RTCs per 100,000 inhabitants over the last decades; from 18.6 to 4.9 in Australia, 14.5 to 2.9 in Norway, 11.1 to 3.6 in Spain, and 19.3 to 10.3 in the United States. The number of alcohol-related fatal RTCs also decreased during the same time period. The proportion of fatal RTCs related to non-alcohol drugs increased, particularly for cannabis and stimulants. A general challenge when comparing alcohol and drug findings in biological samples from several countries is connected to differences in study design, particularly the time period for performing roadside surveys, biological matrix types, drugs included in the analytical program, and the cutoff limits used for evaluation of results. For RTC fatalities, the cases included are based on the police requests for legal autopsy or drug testing, which may introduce a significant selection bias. General comparisons between high-income countries and low- and middle-income countries as well as a discussion of possible future trends are included.
TL;DR: A comprehensive review of international literature on countermeasures that address DUIC points to the need for a long-term commitment to rigorously evaluate, using multiple methods, the impact of general and specific deterrent DUIC countermeasures.
TL;DR: An exhaustive review of the current mechanisms to detect four basic physiological behavior states (drowsy, drunk, driving under emotional state disorders and distracted driving), and a middleware architecture is proposed that seeks to improve the car driving experience of the driver and extend security mechanisms for the surrounding individuals.
Abstract: The emergence of Body Sensor Networks (BSNs) constitutes a new and fast growing trend for the development of daily routine applications. However, in the case of heterogeneous BSNs integration with Vehicular ad hoc Networks (VANETs) a large number of difficulties remain, that must be solved, especially when talking about the detection of human state factors that impair the driving of motor vehicles. The main contributions of this investigation are principally three: (1) an exhaustive review of the current mechanisms to detect four basic physiological behavior states (drowsy, drunk, driving under emotional state disorders and distracted driving) that may cause traffic accidents is presented; (2) A middleware architecture is proposed. This architecture can communicate with the car dashboard, emergency services, vehicles belonging to the VANET and road or street facilities. This architecture seeks on the one hand to improve the car driving experience of the driver and on the other hand to extend security mechanisms for the surrounding individuals; and (3) as a proof of concept, an Android real-time attention low level detection application that runs in a next-generation smartphone is developed. The application features mechanisms that allow one to measure the degree of attention of a driver on the base of her/his EEG signals, establish wireless communication links via various standard wireless means, GPRS, Bluetooth and WiFi and issue alarms of critical low driver attention levels.
TL;DR: Results show the possibility to detect prolonged excessive alcohol consumption, even if the BAC is below the legal threshold of 1.6 ‰ for driving aptitude assessment, in “driving under the influence of alcohol” cases.
Abstract: Phosphatidylethanol (PEth) is considered as specific biomarker of alcohol consumption. Due to accumulation after repeated drinking, PEth is suitable to monitor long-term drinking behavior. To examine the applicability of PEth in "driving under the influence of alcohol" cases, 142 blood samples with blood alcohol concentrations (BAC) ranging from 0.0-3.12‰ were analyzed for the presence of PEth homologues 16:0/18:1 (889 ± 878 ng/mL; range
TL;DR: This review covers dried blood spots, dried urine spots, sweat and skin surface lipids, oral fluid, and meconium (ethanol, EtG, FAEEs), umbilical cord and placenta (EtG/EtS and PEth 16:0/18:1).
TL;DR: The nine effective minimum legal drinking age 21 (MLDA-21) laws are estimated to be currently saving approximately 1,135 lives annually, yet only five states have enacted all nine laws.
Abstract: Objective:Over the last two decades, many states have adopted several of the 20 laws that aim to control youth access to and possession of alcohol and prevent underage drinking in the United States. However, many of these laws have not been evaluated since their adoption. The objective of this study was to determine which minimum legal drinking age 21 (MLDA-21) laws currently have an effect on underage drinking-and-driving fatal crashes.Method:We updated the effective dates of the 20 MLDA-21 laws examined in this study and used scores of each law’s strengths and weaknesses. Our structural equation model included the 20 MLDA-21 laws, impaired driving laws, seat belt safety laws, economic strength, driving exposure, beer consumption, and fatal crash ratios of drinking-to-nondrinking drivers under age 21.Results:Nine MLDA-21 laws were associated with significant decreases in fatal crash ratios of underage drinking drivers: possession of alcohol (-7.7%), purchase of alcohol (-4.2%), use alcohol and lose your ...
TL;DR: A broad targeted screening method based on broadband collision-induced dissociation (bbCID) ultra-performance liquid chromatography high-resolution time-of-flight mass spectrometry (UPLC-HR-TOF-MS) was developed and evaluated and was shown to combine high sensitivity with a very broad scope that has not previously been reported in toxicological whole blood screening when using only one injection.
TL;DR: The required limit of quantification for THC of 1 μg/L in driving under the influence of cannabis cases in Germany (and other countries) can be reached and the method can be employed in that context and the first publication on a comprehensively automated classical liquid-liquid extraction workflow in the field of forensic toxicological analysis is published.
Abstract: The analysis of Δ9-tetrahydrocannabinol (THC) and its metabolites 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC), and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH) from blood serum is a routine task in forensic toxicology laboratories. For examination of consumption habits, the concentration of the phase I metabolite THC-COOH is used. Recommendations for interpretation of analysis values in medical-psychological assessments (regranting of driver’s licenses, Germany) include threshold values for the free, unconjugated THC-COOH. Using a fully automated two-step liquid-liquid extraction, THC, 11-OH-THC, and free, unconjugated THC-COOH were extracted from blood serum, silylated with N-methyl-N-(trimethylsilyl) trifluoroacetamide (MSTFA), and analyzed by GC/MS. The automation was carried out by an x-y-z sample robot equipped with modules for shaking, centrifugation, and solvent evaporation. This method was based on a previously developed manual sample preparation method. Validation guidelines of the Society of Toxicological and Forensic Chemistry (GTFCh) were fulfilled for both methods, at which the focus of this article is the automated one. Limits of detection and quantification for THC were 0.3 and 0.6 μg/L, for 11-OH-THC were 0.1 and 0.8 μg/L, and for THC-COOH were 0.3 and 1.1 μg/L, when extracting only 0.5 mL of blood serum. Therefore, the required limit of quantification for THC of 1 μg/L in driving under the influence of cannabis cases in Germany (and other countries) can be reached and the method can be employed in that context. Real and external control samples were analyzed, and a round robin test was passed successfully. To date, the method is employed in the Institute of Legal Medicine in Giessen, Germany, in daily routine. Automation helps in avoiding errors during sample preparation and reduces the workload of the laboratory personnel. Due to its flexibility, the analysis system can be employed for other liquid-liquid extractions as well. To the best of our knowledge, this is the first publication on a comprehensively automated classical liquid-liquid extraction workflow in the field of forensic toxicological analysis.